Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada.
Obesity (Silver Spring). 2013 Feb;21(2):266-73. doi: 10.1002/oby.20266.
Numerous indexes of adiposity have been proposed and are currently in use in clinical practice and research. However, the correlation of these indexes with measures of vascular health remain poorly defined. This study investigated which measure of adiposity is most strongly associated with endothelial function.
Data from the Firefighters And Their Endothelium (FATE) study was used. The relationships between three measures of vascular function: flow-mediated dilation (FMD), hyperemic velocity time integral (VTI), and hyperemic shear stress (HSS), and five measures of adiposity: BMI, waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and body adiposity index (BAI) were tested. Univariate comparisons were made, and subsequently models adjusted for traditional risk factors were constructed.
A total of 1,462 male firefighters (mean age 49 ± 9) without cardiovascular disease comprised the study population. No measure of adiposity correlated with FMD; all five measures of adiposity were negatively correlated with VTI and HSS (P values <0.0001), with WHtR most strongly correlated with VTI, and WC most strongly correlated with HSS (both P < 0.05). In models including all five measures of obesity simultaneously, BMI, WC, and WHtR were all predictive of HSS (all P values <0.05), and BMI and WHR were both predictive of VTI (P values <0.05).
Anthropometric measures of adiposity may help refine estimations of atherosclerotic burden. BMI was most consistently associated with endothelial dysfunction, but measures of adiposity that reflect distribution of mass were additive.
目前已有许多肥胖指数被提出并应用于临床实践和研究中。然而,这些指数与血管健康指标的相关性仍未明确界定。本研究旨在探讨哪种肥胖指标与内皮功能的相关性最强。
本研究使用消防员及其内皮功能(FATE)研究的数据。分别测试三种血管功能指标(血流介导的扩张度(FMD)、充血速度时间积分(VTI)和充血切应力(HSS))与五种肥胖指标(BMI、腰围(WC)、腰臀比(WHR)、腰高比(WHtR)和体脂指数(BAI))之间的关系。进行单变量比较,然后构建调整传统危险因素的模型。
共有 1462 名无心血管疾病的男性消防员(平均年龄 49±9 岁)纳入研究人群。没有肥胖指标与 FMD 相关;五种肥胖指标均与 VTI 和 HSS 呈负相关(P 值均<0.0001),其中 WHtR 与 VTI 相关性最强,WC 与 HSS 相关性最强(均 P<0.05)。在同时纳入五种肥胖指标的模型中,BMI、WC 和 WHtR 均与 HSS 相关(均 P 值<0.05),而 BMI 和 WHR 均与 VTI 相关(P 值<0.05)。
肥胖的人体测量指标可能有助于细化对动脉粥样硬化负担的评估。BMI 与内皮功能障碍最一致相关,但反映脂肪分布的肥胖指标是相加的。